Oxygen Use After Lung Cancer Surgery

Background. There are no published reports on predictors of oxygen (O-2) use after lung cancer surgery. The prospect of O-2 use after lung cancer surgery may affect a patient's therapy choice. Methods. The Surveillance, Epidemiology, and End Results (SEER)-Medicare data set was queried to identify patients diagnosed with primary lung cancer (stage I/H) who underwent surgical resection from 1994 to 2010. Patients with a second resection within 6 months of their first and those with preoperative O-2 use were excluded. Multivariable logistic regression was performed to evaluate the odds ratios and 95% confidence intervals of O-2 use (defined as being billed for home O-2) after discharge for lung cancer surgery. Results. Of 21,245 eligible patients from 1994 to 2010, 3,255 (15.3%) were billed for O-2 use in the first month of discharge. Of these, 13.7% (447 of 3,255) stopped using within 1 month, and 1.47% died. By 6 months, an additional 6.7% died, and 46.27% (1,384 of 2,991) were still alive and using O-2. Discharge on O-2 was associated with higher odds of death within 6 months (odds ratio, 1.35; 95% confidence interval, 1.17 to 1.55). The significant, independent risk factors for O-2 use at discharge were procedure, sex, race, histology, pulmonary comorbidities, obesity, length of stay, pulmonary complications, and discharge mode. Conclusions. Home O-2 use after lung cancer surgery comprises a sizable portion of this population and is correlated with death in the first 6 months. Various predictors significantly increased the risk of O-2 use at discharge. However, 49.3% of those originally discharged on O-2 were alive and off O-2 at 6 months. (C) 2018 by The Society of Thoracic Surgeons